Editorial: Wrong to paint ER fee as affront to fairness

Wednesday

Sep 23, 2009 at 12:01 AMSep 23, 2009 at 11:22 PM

It’s welcome news to health care consumers that Milton Hospital will no longer charge a premium for late-night emergency room visits but suggestions that such fees exceed the bounds of fair practice seem rooted more in drama than trauma.

It’s welcome news to health care consumers that Milton Hospital will no longer charge a premium for late-night emergency room visits but suggestions that such fees exceed the bounds of fair practice seem rooted more in drama than trauma.

Unlike police and fire protection, medical care is a service for which we pay based on usage.

Critics of the $30 surcharge to ER patients seen between 10 p.m. and 8 a.m., say it is unfair because people cannot choose when they will need such services. That unpredictability, however, has not stopped countless other industries from charging extra for after-hours assistance. If your furnace dies, your toilet clogs or your basement floods in the middle of the night you’re almost certain to pay a premium for help.

Milton Hospital is one of five hospitals served by the Harvard Medical Faculty Physicians group. In January, the group instituted the surcharge, it said, to help defray overnight staffing costs. The other hospitals in the group are Beth Israel Deaconess Medical Center-Boston, Beth Israel Deaconess-Needham, Saint Vincent Medical Center in Worcester and Nashoba Valley Medical Center in Ayer.

“This fee is designed to offset the cost of 24-hour, seven-day access to emergency medical services and is in compliance with state and federal law and all contracts Beth Israel Deaconess Medical Center and Harvard physicians group have with health care insurers,” doctors in the group stated.

We’ll grant that such surcharges are far from universal. Officials at Quincy Medical Center, South Shore Hospital in Weymouth and Jordan Hospital in Plymouth said Tuesday that they do not charge more for late-night emergency room treatment. But the physicians group that serves Milton Hospital said the fee can be found at hospitals around the country.

We’re sure the Service Employees International Union, which spearheaded the effort to revoke the fee, supports workers’ night differentials so you might think they would support efforts to cover the cost of paying them.

The issue, however, is more than a simple matter of patients’ rights.

SEIU Local 1199 – which represents about 34,000 health care workers in Massachusetts, in addition to about 300,000 in New York, New Jersey, Maryland and Washington D.C. – is seeking to organize workers at Beth Israel Deaconess Medical Center in Boston.

Milton Hospital now says it will offer refunds to those who paid the fee. It’s a decision likely guided in part by a desire to quell what has become a public relations problem. It might also stanch animosity among those who feel skyrocketing hospital costs are a big part of the nation’s health care crisis.

What is clear, however, is this is less about greed and the greater good than it is about gamesmanship.